Early Detection and Treatment of Psychosis: The Bern Child and Adolescent Psychiatric Perspective

Table 4

Ultrahigh risk criteria according to the Structured Interview for Psychosis-Risk Syndromes (SIPS) [115].

“Brief limited intermittent psychotic symptom” (BLIPS) syndrome
(i) At least any 1 of the following SIPS P-items scored 6 “severe and psychotic”:
(a) P1 unusual thought content/delusional ideas^a
(b) P2 suspiciousness/persecutory ideas
(c) P3 grandiose ideas
(d) P4 perceptual abnormalities/hallucinations
(e) P5 disorganized communication
(ii) First appearance in the past three months
(iii) Present for at least several minutes per day at a frequency of at least once per month but less than 7 days
“Attenuated psychotic symptom” (APS) syndrome^b
(i) At least any 1 of the following SIPS P-items scored 3 “moderate” to 5 “severe but not psychotic”:
(a) P1 unusual thought content/delusional ideas
(b) P2 suspiciousness/persecutory ideas
(c) P3 grandiose ideas
(d) P4 perceptual abnormalities/hallucinations
(e) P5 disorganized communication
(ii) First appearance within the past year or current rating one or more scale points higher compared to 12 months ago
(iii) Symptoms have occurred at an average frequency of at least once per week in the past month
“Genetic risk and functional deterioration” (GRFD) syndrome
(1) Patient meets criteria for schizotypal personality disorder according to SIPS
(2) Patient has 1st degree relative with a psychotic disorder
(3) Patient has experienced at least 30% drop in the global assessment of functioning (GAF) score over the last month compared to 12 months ago
1 and 3 or 2 and 3 or all are met

Item numbers refer to the SIPS.
^bIn the definition of the Attenuated Psychosis Syndrome of DSM-5, requirements (i) to (iii) are complimented a fourth requirement; that is, significant disability or distress is caused by APS.