Negative symptoms in children and adolescents with early-onset psychosis and at clinical high-risk for psychosis: systematic review and meta-analysis

被引:24
作者
de Pablo, Gonzalo Salazar [1 ,2 ,3 ,4 ]
Catalan, Ana [2 ,5 ]
Vaquerizo Serrano, Julio [1 ]
Pedruzo, Borja [6 ]
Alameda, Luis [7 ,8 ,9 ]
Sandroni, Veronica [10 ,11 ]
Armendariz, Alvaro [12 ]
Rodriguez, Victoria [13 ]
Arango, Celso [4 ]
Moreno, Carmen [4 ]
Downs, Johnny [1 ]
Abbott, Chris [3 ]
Shin, Jae Il [14 ]
Solmi, Marco [2 ,15 ,16 ,17 ]
Fusar-Poli, Paolo [2 ,18 ,19 ,20 ]
Correll, Christoph U. [17 ,21 ,22 ,23 ]
机构
[1] Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Child & Adolescent Psychiat, London, England
[2] Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Psychosis Studies, Early Psychosis Intervent & Clin Detect EPIC Lab, London, England
[3] South London & Maudsley NHS Fdn Trust, Child & Adolescent Mental Hlth Serv, London, England
[4] Univ Complutense, Dept Child & Adolescent Psychiat, Inst Psychiat & Mental Hlth, Hosp Gen Univ Gregorio Maranon,Sch Med,IiSGM,CIBE, Madrid, Spain
[5] Univ Basque Country, Biocruces Bizkaia Hlth Res Inst, Basurto Univ Hosp, Dept Mental Hlth,UPV EHU,Fac Med & Odontol, Campus Leioa, Vizcaya, Spain
[6] Basurto Univ Hosp, Dept Psychiat, Bilbao, Spain
[7] Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Psychosis Studies, London, England
[8] Univ Hosp CHUV, Serv Gen Psychiat, Treatment & Early Intervent Psychosis Program, Lausanne, Switzerland
[9] Univ Seville, Hosp Univ Virgen del Rocio, Dept Psiquiatria, Ctr Invest Biomed Red Salud Mental CIBERSAM,Inst, Seville, Spain
[10] Univ Paris Cite, Fac Med, Dept Psychiat, Paris, France
[11] Grp Hosp Paul Guiraud, Dept Psychiat, Villejuif, France
[12] Hosp St Joan de Deu Barcelona, Dept Psychiat & Psychol, Barcelona, Spain
[13] Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Psychosis Studies, London, England
[14] Yonsei Univ, Coll Med, Dept Paediat, Seoul, South Korea
[15] Univ Ottawa, Dept Psychiat, Ottawa, ON, Canada
[16] Ottawa Hosp, Dept Mental Hlth, Ottawa, ON, Canada
[17] Charite, Dept Child & Adolescent Psychiat, Berlin, Germany
[18] Univ Pavia, Dept Brain & Behav Sci, Pavia, Italy
[19] South London & Maudsley NHS Fdn Trust, OASIS Serv, London, England
[20] South London & Maudsley NHS Fdn Trust, Natl Inst Hlth Res, Maudsley Biomed Res Ctr, London, England
[21] Zucker Hillside Hosp, Dept Psychiat, Northwell Hlth, Glen Oaks, NY USA
[22] Zucker Sch Med Hofstra Northwell, Dept Psychiat & Mol Med, Hempstead, NY USA
[23] Feinstein Inst Med Res, Ctr Psychiat Neurosci, Manhasset, NY USA
基金
英国医学研究理事会;
关键词
Early-onset psychosis; psychotic disorders; meta-analysis; clinical high risk of psychosis; prevention; ULTRA-HIGH RISK; OPEN-LABEL TRIAL; SCHIZOPHRENIA-SPECTRUM DISORDERS; DOUBLE-BLIND; 1ST-EPISODE PSYCHOSIS; UNTREATED PSYCHOSIS; 1ST EPISODE; NEUROCOGNITIVE PERFORMANCE; ANTIPSYCHOTIC TREATMENT; SOCIAL SUPPORT;
D O I
10.1192/bjp.2022.203
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
BackgroundEarly-onset psychosis (EOP) refers to the development of a first episode of psychosis before 18 years of age. Individuals at clinical high risk for psychosis (CHR-P) include adolescents and young adults, although most evidence has focused on adults. Negative symptoms are important prognostic indicators in psychosis. However, research focusing on children and adolescents is limited. AimsTo provide meta-analytical evidence and a comprehensive review of the status and advances in the diagnosis, prognosis and treatment of negative symptoms in children and adolescents with EOP and at CHR-P. MethodPRISMA/MOOSE-compliant systematic review (PROSPERO: CRD42022360925) from inception to 18 August 2022, in any language, to identify individual studies conducted in EOP/CHR-P children and adolescents (mean age <18 years) providing findings on negative symptoms. Findings were systematically appraised. Random-effects meta-analyses were performed on the prevalence of negative symptoms, carrying out sensitivity analyses, heterogeneity analyses, publication bias assessment and quality assessment using the Newcastle-Ottawa Scale. ResultsOf 3289 articles, 133 were included (n = 6776 EOP, mean age 15.3 years (s.d. = 1.6), males = 56.1%; n = 2138 CHR-P, mean age 16.1 years (s.d. = 1.0), males = 48.6%). There were negative symptoms in 60.8% (95% CI 46.4%-75.2%) of the children and adolescents with EOP and 79.6% (95% CI 66.3-92.9%) of those at CHR-P. Prevalence and severity of negative symptoms were associated with poor clinical, functional and intervention outcomes in both groups. Different interventions were piloted, with variable results requiring further replication. ConclusionsNegative symptoms are common in children and adolescents at early stages of psychosis, particularly in those at CHR-P, and are associated with poor outcomes. Future intervention research is required so that evidence-based treatments will become available.
引用
收藏
页码:282 / 294
页数:13
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