Longitudinal outcome of attenuated positive symptoms, negative symptoms, functioning and remission in people at clinical high risk for psychosis: a meta-analysis

被引：44

作者：

Salazar de Pablo, Gonzalo ^{[1
,2
,3
]}

Besana, Filippo ^{[4
]}

Arienti, Vincenzo ^{[4
]}

Catalan, Ana ^{[5
,6
]}

Vaquerizo-Serrano, Julio ^{[2
,3
,6
]}

Cabras, Anna ^{[7
]}

Pereira, Joana ^{[8
]}

Soardo, Livia ^{[4
]}

Coronelli, Francesco ^{[4
]}

Kaur, Simi ^{[6
]}

da Silva, Josette ^{[6
]}

Oliver, Dominic ^{[1
]}

Petros, Natalia ^{[6
]}

Moreno, Carmen ^{[2
]}

Gonzalez-Pinto, Ana ^{[9
]}

Diaz-Caneja, Covadonga M. ^{[2
]}

Shin, Jae Il ^{[10
]}

Politi, Pierluigi ^{[4
]}

Solmi, Marco ^{[1
,11
]}

Borgatti, Renato ^{[4
,12
]}

Mensi, Martina Maria ^{[4
,12
]}

Arango, Celso ^{[2
]}

Correll, Christoph U. ^{[13
,14
,15
,16
]}

McGuire, Philip ^{[6
,17
,18
]}

Fusar-Poli, Paolo ^{[1
,4
,17
,18
]}

机构：

[1] Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Psychosis Studies, Early Psychosis Intervent & Clin Detect EPIC Lab, London, England

[2] Univ Complutense, Hosp Gen Univ Gregorio Maranon, Sch Med,CIBERSAM,Inst Invest Sanitaria Gregorio M, Inst Psychiat & Mental Hlth,Dept Child & Adolesce, Madrid, Spain

[3] Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Child & Adolescent Psychiat, London, England

[4] Univ Pavia, Dept Brain & Behav Sci, Pavia, Italy

[5] Basurto Univ Hosp, Fac Med & Dent, Mental Hlth Dept, Biocruces Bizkaia Hlth Res Inst,UPV EHU, Vizcaya, Spain

[6] Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Psychosis Studies, London, England

[7] Univ Roma La Sapienza, Dept Neurol & Psychiat, Rome, Italy

[8] Lisbon Psychiat Hosp Ctr, Lisbon, Portugal

[9] Hosp Univ Araba, UPV EHU, Serv Psiquiatria, Bioaraba,Ctr Invest Biomed Red Salud Mental CIBER, Araba, Spain

[10] Yonsei Univ, Dept Paediat, Coll Med, Seoul, South Korea

[11] Univ Padua, Neurosci Dept, Padua, Italy

[12] IRCCS Mondino Fdn, Child & Adolescent Neuropsychiat Unit, Pavia, Italy

[13] Zucker Hillside Hosp, Dept Psychiat, Northwell Hlth, Glen Oaks, NY USA

[14] Zucker Sch Med Hofstra Northwell, Dept Psychiat & Mol Med, Hempstead, NY USA

[15] Feinstein Inst Med Res, Ctr Psychiat Neurosci, Manhasset, NY USA

[16] Charite, Dept Child & Adolescent Psychiat, Berlin, Germany

[17] South London & Maudsley Natl Hlth Serv Fdn Trust, OASIS Serv, London, England

[18] South London & Maudsley NHS Fdn Trust, Maudsley Biomed Res Ctr, Natl Inst Hlth Res, London, England

来源：

ECLINICALMEDICINE | 2021年 / 36卷

关键词：

QUALITY-OF-LIFE; ULTRA-HIGH RISK; 1ST-EPISODE PSYCHOSIS; PREDICTION; SCHIZOPHRENIA; INDIVIDUALS; STATE; DEPRESSION; INTERVENTIONS; PROGRESSION;

D O I：

10.1016/j.eclinm.2021.100909

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Little is known about clinical outcomes other than transition to psychosis in people at Clinical High-Risk for psychosis (CHR-P). Our aim was to comprehensively meta-analytically evaluate for the first time a wide range of clinical and functional outcomes beyond transition to psychosis in CHR-P individuals. Methods: PubMed and Web of Science were searched until November 2020 in this PRISMA compliant metaanalysis (PROSPERO:CRD42020206271). Individual longitudinal studies conducted in individuals at CHR-P providing data on at least one of our outcomes of interest were included. We carried out random-effects pairwise meta-analyses, meta-regressions, and assessed publication bias and study quality. Analyses were two-tailed with alpha=0.05. Findings: 75 prospective studies were included (n=5,288, age=20.0 years, females=44.5%). Attenuated positive symptoms improved at 12 (Hedges' g=0.753, 95%CI=0.495-1.012) and 24 (Hedges' g=0.836, 95%CI=0.463-1.209), but not >= 36 months (Hedges' g=0.315. 95%CI=0.176-0.806). Negative symptoms improved at 12 (Hedges' g=0.496, 95%CI=0.315 -0.678), but not 24 (Hedges' g=0.499, 95%CI=-0.137-1.134) or >= 36 months (Hedges' g=0.033, 95%CI=0.439-0.505). Depressive symptoms improved at 12 (Hedges' g=0.611, 95%CI=0.441 -0.782) and 24 (Hedges' g=0.583, 95%CI=0.364 -0.803), but not >= 36 months (Hedges' g=0.512 95%CI=0.337-1.361). Functioning improved at 12 (Hedges' g=0.711, 95%CI=0.488-0.934), 24 (Hedges' g=0.930, 95%CI=0.553-1.306) and >= 36 months (Hedges' g=0.392, 95%CI=0.117-0.667). Remission from CHRP status occurred in 33.4% (95%CI=22.6-44.1%) at 12 months, 41.4% (95%CI=32.3-50.5%) at 24 months and 42.4% (95%CI=23.4-61.3%) at >= 36 months. Heterogeneity across the included studies was significant and ranged from I-2=53.6% to I-2=96.9%. The quality of the included studies (mean +/- SD) was 4.6 +/- 1.1 (range=2-8). Interpretation: CHR-P individuals improve on symptomatic and functional outcomes over time, but these improvements are not maintained in the longer term, and less than half fully remit. Prolonged duration of care may be needed for this patient population to optimize outcomes. (C) 2021 The Authors. Published by Elsevier Ltd.

引用

页数：10

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