Insular volume abnormalities associated with different transition probabilities to psychosis

Background Although individuals vulnerable to psychosis show brain volumetric abnormalities, structural alterations underlying different probabilities for later transition are unknown. The present study addresses this issue by means of voxel-based morphometry (VBM). Method We investigated grey matter volume (GMV) abnormalities by comparing four neuroleptic-free groups: individuals with first episode of psychosis (FEP) and with at-risk mental state (ARMS), with either long-term (ARMS-LT) or short-term ARMS (ARMS-ST), compared to the healthy control (HC) group. Using three-dimensional (3D) magnetic resonance imaging (MRI), we examined 16 FEP, 31 ARMS, clinically followed up for on average 3 months (ARMS-ST, n=18) and 4.5 years (ARMS-LT, n=13), and 19 HC. Results The ARMS-ST group showed less GMV in the right and left insula compared to the ARMS-LT (Cohen's d 1.67) and FEP groups (Cohen's d 1.81) respectively. These GMV differences were correlated positively with global functioning in the whole ARMS group. Insular alterations were associated with negative symptomatology in the whole ARMS group, and also with hallucinations in the ARMS-ST and ARMS-LT subgroups. We found a significant effect of previous antipsychotic medication use on GMV abnormalities in the FEP group. Conclusions GMV abnormalities in subjects at high clinical risk for psychosis are associated with negative and positive psychotic symptoms, and global functioning. Alterations in the right insula are associated with a higher risk for transition to psychosis, and thus may be related to different transition probabilities.

Préparation à la transition de l'école obligatoire à la formation professionelle

Cette contribution analyse les contraintes et opportunités issus de la transition entre l’école obligatoire et la formation professionnelle en Suisse. L’ambition est de montrer que des facteurs psychologiques et structuraux sont essentiels pour comprendre les inégalités observées lors de cette transition. Les résultats de différentes études empiriques montrent que des facteurs associés à la personnalité, au support social, et à l’engagement personnel dans la préparation au choix de carrière ont une incidence sur les différences interindividuelles en termes d’adaptabilité de carrière et de congruence du choix professionnel tel qu’observés avant la transition. Les implications pour la pratique dans le domaine du conseil en orientation seront présentées.