Currently, two clinical high risk (CHR) approaches to the early detection of psychoses prevail: the ultra-high risk (UHR) criteria and basic symptom criteria. Both were developed and initially validated on predominately adult samples; their subsequent employment in child and adolescent samples was done with little consideration of developmental, i.e., age-related, issues. The important role of age, however, was recently highlighted by lower conversion rates to psychoses in clinical child and adolescent samples as well as by a higher prevalence and lower clinical significance of UHR and basic symptoms in children and adolescents of the community. Thereby, an age threshold of around the turn from early to late adolescence was indicated for UHR symptoms and of around the turn from adolescence to adulthood for basic symptoms.
In our symposium, we will further investigate age-specific requirements in the definition and treatment of CHR states of psychoses. To this aim, first, age-effects on the presentation of UHR symptoms in a clinical sample will be explored, following the methods employed in community samples. Next, the impact of age on the presence and severity of “co”-morbid disorders will be explored in a clinical child and adolescent sample of CHR patients of the Bi-national Evaluation of At-Risk Symptoms in children and adolescents (BEARS-Kid) study. This will be followed by a critical review of diagnostically challenges in children and adolescents associated to disorders of childhood and adolescence. Finally, based on one-year follow-up data of the naturalistic BEARS-Kid study, the efficiency of different interventions with regard to CHR symptoms in children and adolescents clinically considered at CHR of psychoses will be examined. Overall, the symposium shall highlight the special efforts required for a precise and efficient prevention of psychosis in children and adolescence and convey ways to adequately address this topic for the time being.