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Master Thesis

Prise en charge thérapeutique des états mentaux à risque de transition vers un trouble psychotique : une revue de la littérature

Abstract : Early detection and intervention of subjects developing a psychotic disorder has been a topic of interest since the 1990s, with the emergence of the concept of at-risk mental states of transition to psychosis or “ultra-high-risk subjects”. Once high-risk subjects have been detected, the treatment raises question: what are the possible interventions for subjects asking for help but the majority of whom will not make a psychotic conversion? This thesis explores this question through a synthesis of data from the literature in order to determine whether it is possible to recommend specific interventions that can prevent psychotic transition, improve the symptoms, the functioning and the quality of life of the subject. The published studies examine on one hand the pharmacological treatments such as antipsychotic, antidepressants, omega-3 and other neuroprotective agents, and on the other hand non-pharmacological treatments such as cognitive-behavioural therapy, cognitive remediation and family psychotherapy. The various meta-analyses on this topic suggest that early intervention is effective in reducing the risk of transition to psychosis at 12 months. To date there is no evidence that any specific treatment is more effective than another in reducing the transition rates or in improving functioning or symptoms. International guidelines have been established advising the use of cognitive-behavioural therapy as first-line treatment. The use of antipsychotics should be reserved for subjects with severe symptoms resistant to psychosocial interventions. Research on this topic needs to be pursued, and it would seem worthwhile to address interventions in term of their effectiveness in improving functioning, and to consider a clinical-staging model of intervention.
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Submitted on : Friday, September 11, 2020 - 3:46:16 PM
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Sophie Lafon. Prise en charge thérapeutique des états mentaux à risque de transition vers un trouble psychotique : une revue de la littérature. Sciences du Vivant [q-bio]. 2020. ⟨dumas-02936702⟩



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